The aim: The identification and determination of needs that the population of older age groups have in medical and social services on the basis of health data and the results of a survey. Material and methods: Because of bibliographic, epidemiological, medical-statistical, analytical methods the research has investigated the problems of healthy aging, tendencies in population health of the population of Ukraine of senior age groups during 2000-2017, features and tendencies of health of a sample contingent of urban population of elderly age according to appeals in health care facilities during 2009-2019. The use of the sociological method, the self-evaluation of elderly people of their own health, characteristics of lifestyle and medical activity are determined, the needs of older people in medical and social services were assessed. Results: Negative tendencies to increase during 2000-2017 the prevalence of pathology among the population older than working age by 22.8%, including blood diseases in 2 times, endocrine system – in 1.8 times, urogenital system – by 1.5 times, digestive organs – by 1.4 times, tumors and nervous system – by 1.3 times. Among the urban elderly population, the prevalence of sensory diseases, including ear and eye diseases, endocrine disorders, injuries and poisonings, has increased, and mental health indicators have deteriorated. The sociological survey found a low level of self-esteem (31.5±3.5 per 100 had health problems, 10.1±2.3 are significant). Self-medication was practiced by 76.4±3.2 per 100 respondents, 74.2±3.3 were not followed or they violated the doctor's recommendations. 56.2 ±3.7 per 100 respondents had physical examinations in the non-right time 29.7±3.4 had not it. There was a significant prevalence of risk factors, including hypodynamics (21.9±3.1 per 100), tobacco use (29.8±3.4), malnutrition (37.1±3.6), overweight (obesity) (32, 6±3.5), arterial hypertension (37.6±3.6), hypercholesterolemia (28.7±3.4), glucosemia 16.3±2.8). The research has discovered the needs of older people in health care and social services, inter alia in preventive counseling (65.2±3.6 per 100), the introduction of electronic technologies in health care (68.5±3.5), information educational services on health issues (67.4±3.5), provision of services in hospitals at home (66.3±3.5), in increasing the availability of rehabilitation (43.8±3.7), specialized counseling (34.3±3.6) and emergency medical care (16.2±2.8), improvement of socio-economic determinants (78.0±3.1), introduction of activities (48.3±3.7), joint training programs for older people (42.1±3.7), the development of certain skills, the use of technical means, assistive devices (67.4±3.5), the formation of a conducive to better health environment (58, 4±3.7). Conclusions: The low level of the elderly people's health, the tendency to increase the burden of disease, the prevalence of risk factors for disease and low medical activity lead to significant needs for medical and social services of preventive, treatment-diagnostic, rehabilitation, improving socio-economic determinants, measures to reduce social isolation.
The aim: Establishing the characteristic features and morbidity rate of genitourinary diseases in order to substantiate the need for health care services. Materials and methods: The article uses bibliographic, medical, statistical and content analysis, as well as analytical methods. We have analyzed the sex-age characteristics of the morbidity rate of genitourinary diseases, with the morbidity rates among different sex-age groups of the population in 2015-2022 evaluated. Results: Diseases of the genitourinary system constitute a significant share in the overall structure of the morbidity rate (7.3%-10.6%) and disease prevalence (6.1%-7.3%) among adults. In 2015-2022, the dynamics of the morbidity rate of genitourinary diseases and their prevalence were characterized by a constant increase until 2019, with a subsequent decrease until 2022. Such trends in the morbidity rate and prevalence of genitourinary diseases among people may be related to the impact of the COVID-19 pandemic, which led to the restricted access to health care services as a result of taking measures to prevent the spread of infection, excessive load on the network of health care facilities within the pandemic period, etc. The features of prevalence and dynamics of the incidence of genitourinary diseases in adolescents, adults, and persons of older age groups are determined. Conclusions: The identified sex-age characteristics of the morbidity rate of genitourinary diseases, prevailing nosologies in certain age and sex groups will become the basis for substantiating measures to improve the quality of medical care, taking into account the principle of patient centricity and integration of care.
The aim: Conducting an analysis of indicators of the dynamics and prevalence of the main classes of chronic non-infectious diseases of the contingent attached to a multidisciplinary health care institution of the population contingent, to determine the main predictive trends of morbidity for the formation of a strategy for the prevention of diabetes complications, in particular, one of the most dangerous complications - diabetic retinopathy. Materials and methods: In our work, we used the bibliosemantic method and structural-logical analysis. During the research, we analyzed individual indicators of the health status of patients over 18 years of age, who are attached for medical care to the State Scientific Institution «Scientific and Practical Center of Preventive and Clinical Medicine» of the State Administrative Department. Our main focus is on the prevalence of diabetes and its complications. Conclusions: The stability of the dynamics of the general morbidity indicators for the most common nosological forms of diseases of the main rating classes of diseases indicates the effectiveness of measures for the prevention and early diagnosis of diseases among the attached contingent. The levels of coverage of dispensary supervision of patients of SIS «SPC PCP» SAD are quite high (more than 90%). Performing preventive dynamic observations of patients with diabetes and diabetic retinopathy and observing the basic principles of integrated management allows to improve the results of treatment and the prognosis of the course of the disease, because the onset of retinopathy often occurs without obvious symptoms. An important factor is the constant updating and implementation of medical and technological documents for the constant improvement of the quality of medical care.
The aim: identifying the characteristics and trends of inequalities in the health of the population to substantiate the educational content of the curriculum for the training of Master in Public Health. Materials and methods: Bibliographic, sociological, medical-statistical and information-analytical methods were used in the study. Ukraine’s healthcare institutions were the scientific base of the study. The data on the average life expectancy, morbidity, mortality, satisfaction of medical needs of different groups of the population for revealing the social gradient are analyzed. Documents on strategies to reduce health inequalities have been examined. Results: Health inequalities between WHO countries have been identified, including a difference in the average life expectancy at birth of 17.1 years in premature mortality due to differences in the levels of economic development of countries. The inequality in the prevalence of diseases and the difference in the satisfaction of specific medical needs among the first and tenth decile population of Ukraine were determined. The prevalence of diseases of the genitourinary system in the population older than 60 years with low rates by 27.3% was higher than the figure among financially insured persons. The incidence of ocular pathology among adults with different income levels varied 1.8 times. The provisions of the WHO strategic documents on reducing health inequalities and its protection and on developing the public health system are analyzed. We justify the necessity of expanding the coverage of the problems of reducing disparities in health and health care in the course of training of the Master in Public Health. A modern curriculum “Social Medicine, Public Health” has been developed with the inclusion of inequalities in public health and appropriate educational and methodological support. Conclusion: The strategic goal of reducing inequalities in public health and its care requires integrating these issues into a modern master’s in public health program. The curriculum developed covers various aspects of health inequalities and health care, including the identification and assessment of disparities, the clarification of causes, the identification of counter-measures. Created educational and methodological support allows acquiring theoretical knowledge and practical skills that form the necessary competencies of professionals in the context of overcoming inequalities in health.
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